Introducing CareCode AI (Beta): A Smarter Way to Tackle Denials and Improve Coding Accuracy

In healthcare revenue cycle management, denials remain one of the most persistent and costly challenges. Studies estimate that 10–15% of all claims are initially denied, and nearly 40% of those denials are never worked. Each denial not only delays reimbursement but also forces coding and billing teams into a cycle of rework, appeals, and payer-specific guesswork that eats up valuable staff time and increases administrative overhead.

But what if coders, billers, and revenue cycle teams had a decision support tool at their fingertips—one that learned from payer behavior, flagged risks in real time, and provided faster, more accurate coding guidance?

That’s the promise of CareCode AI.

Why Denials Happen (and Why They Persist)

Denials often stem from a few core issues:

• Coding complexity: ICD-10, CPT, and modifier combinations vary by payer, creating traps for even the most experienced coders.

• Medical necessity gaps: Providers may document clinical justification, but without correct mapping to payer rules, claims are vulnerable to rejection.

• Time pressure: Coders and billers are under pressure to process claims quickly, making it harder to research edge cases or recall nuanced payer policies.

• Lack of visibility: Many organizations don’t have a proactive way to detect denial-prone claims before submission.

The result? Revenue leakage, increased rework costs, and staff burnout.

How CareCode AI Helps

CareCode AI is being built specifically to address these gaps by combining AI-powered coding assistance with payer-specific denial intelligence. In this next phase of development, we’ve launched a usable beta version designed for revenue cycle leaders who want to see what an AI-driven coding and denial-prevention workflow looks like in action.

Here’s what it can do:

• Speed & Efficiency: Generate CPT, ICD-10, and modifier codes directly from SOAP notes in seconds—reducing manual lookups and coding errors.

• Denial Prevention: Flag risks in real time, giving coders and billers the ability to adjust claims before submission.

• Education Tool: Serve as an interactive learning platform for coders, showing why certain codes or modifiers should (or shouldn’t) be applied.

• Decision Support: Provide coders, billers, and auditors with payer-backed insights, helping teams align coding decisions with reimbursement likelihood.

• Scalability: Whether it’s 50 claims a day or 5,000, CareCode AI is designed to work with your team.

Use Cases Across the Revenue Cycle

• For Coding Teams: Faster coding, fewer errors, and improved productivity.

• For Billers & Follow-Up Teams: Insights into denial trends that allow them to focus on high-value follow-up.

• For Revenue Cycle Leaders: A data-driven way to reduce denial rates, improve cash flow, and optimize staff time.

• For Training & Onboarding: Coders learn payer-specific rules as they work, shortening the ramp-up time for new hires.

Be Part of the Beta

We’re inviting a select group of revenue cycle leaders, coders, and billing professionals to test-drive the first beta release of CareCode AI. Your feedback will directly shape how the tool evolves—and you’ll be among the first to see how AI can transform claim accuracy and denial prevention.

👉 Secure Your One-on-One Session Here https://calendar.notion.so/meet/andrew-ez4xx4pd5/tj1154op6

Let’s tackle denials at the source—together.